Posted by Keith Talent on May 8, 2004, at 3:46:01
In reply to Severe anxiety - help, posted by jms600 on May 4, 2004, at 17:12:11
> GAD and social phobia
>
> My doctor has started me on 50mg Amisulpride twice per day - but its just not working.Drop the amisulpride.
> I have been taking Valium, but I seem to have grown quite tolerant to it
Substitute clonazepam (Klonopin) twice daily for diazepam (Valium). Clonazepam is a much more potent, longer acting benzodiazepine, with a reputation for causing both less tolerance and less sedation than diazepam.
> also on Prozac 20mg per day (just come down from 40mg as it was exacerbating my anxiety).
If you have no depression, maybe you could drop the fluoxetine (Prozac). Unfortunately, SSRIs (such as fluoxetine), when used to treat anxiety disorders, usually need much higher dosages than those used to treat depression. Also, antianxiety benefits tend to take at least three or four months to be felt; however, anxiety often gets worse before it gets better. Patients with anxiety disorders often need 80 or 100 mg per day of fluoxetine to get relief. Fluoxetine (in the short term - the first few weeks) can cause worse anxiety than other SSRIs because it antagonises serotonin-2 receptors, which causes release of noradrenaline and dopamine in the cortex. So perhaps Zoloft or Lexapro would be more acceptable to you.
> Any suggestions for medication to try (non-benzo)?
I don't know anything about buspirone, but people here have said it negated the benefits of their antidepressants. I don't think it's widely prescribed. It may be a "failed" drug - not sure. Benzos have been "politically incorrect" for at least 15 years, but they have their place. Don't be put off something that maybe be life-transforming just because of horror stories in the media.
poster:Keith Talent
thread:343335
URL: http://www.dr-bob.org/babble/20040505/msgs/344684.html